| Object: It is very complicated that brachial plexus arrange below the clavicle. So we paid great attention to the correlation of the plexus and the structures around, which plays an important role in the nerve blockings and nerve injuries in clinical. Dissecting and observing the course of the cervical branch of the brachial plexus, the research is about to get the full information of how the nerves organize, constitute, arrange, distribute and adjoin. Moreover, the research will provide reference for anesthesia and surgery.Methods: To approach through the axillary cavity of 15 adult cadavers fixed by formalin, the research dissects the clavicle- bellowing part of brachial plexus as well as observes and measures the constitution, arrangement, distributing and adjoining of the nerve plexus by the help of vernier caliper, ruler, triangular rule, compasses and protractor. All the results, which were accurated to two bit after the decimal point, were analyzed by statistical software SPSS 11.5. The research also took pictures of important structures.Results:1.The measurement results for the clavicle- bellowing part of brachial plexus:The left clavicle- bellowing part of brachial plexus: The distance between the density point of the plexus and sternoclavicular joint is (7.440.11)cm. The distance between the density point of the plexus and the center of clavicle is(0.890.14)cm. The distance between the density point of the plexus and coracoid process is (3.420.27)cm. The distance between the density point of the plexus and front acromion is (5.470.28)cm. The distance between the density point of the plexus and lesser tubercle of humerus is(5.350.59)cm.The right clavicle- bellowing part of brachial plexus: The dista- nce between the density point of the plexus and sternoclavicular joint is (7.710.12)cm. The distance between the density point of the plexus and the center of clavicle is(0.910.08)cm. The distance between the density point of the plexus and coracoid process is (5.820.35)cm. The distance between the density point of the plexus and front acromion is (5.470.28)cm. The distance between the density point of the plexus and lesser tubercle of humerus is(4.760.44)cm.2.The measurement results for the neural trunk of brachial plexus: The left nerve trunk of brachial plexus: The distance between the upper trunk and the center of clavicle is (1.860.31)cm. The distance between the upper trunk and coracoid process is (4.030.55)cm. The distance between the upper trunk and front acromion is (5.720.61)cm. The distance between the upper trunk and lesser tubercle of humerus is (6.210.45)cm. The distance between the inferior trunk and the center of clavicle is(0.840.62)cm. The distance between the inferior trunk and sternoclavicular joint is (6.050.39)cm.The right nerve trunk of brachial plexus: The distance between the upper trunk and the center of clavicle is (1.930.42)cm. The distance between the upper trunk and coracoid process is (4.280.31)cm. The distance between the upper trunk and front acromion is (6.010.54)cm. The distance between the upper trunk and lesser tubercle of humerus is (6.630.82)cm. The distance between the inferior trunk and the center of clavicle is(0.880.47)cm. The distance between the inferior trunk and sternoclavicular joint is(5.970.38)cm.3.The correlation of clavicle- bellowing part of brachial plexus and axillary vessel:The three branches of brachial plexus arrange with axillary artery, through armpit, the lateral and posterior branches locate the outside while the internal locate the post. At the depth of pectoralis minor muscle, they are around the artery and arrange within the axillary sheath.The lateral root of median nerve is coarser, apart with the internal root, arrange along with the axillary artery, and then zigzag to the below where they syntheses the median nerve.4.The measurement results for the nerve branches of brachial plexus:The left clavicle- bellowing part of brachial plexus: The distance between the density point of the plexus and the origin of axillary nerve is (38.742.12)mm. The distance between the density point of the plexus and the origin of muscularcutaneous nerve is (26.98 1.95)mm. The distance between the density point of the plexus and the origin of radial nerve is (31.172.05)mm. The distance between the density point of the plexus and the origin of ulnar nerve is (39.554.01)mm. The distance between the density point of the plexus and the origin of internal root of median nerve is (19.624.48)mm. The distance between the density point of the plexus and the origin of lateral root of median nerve is (15.183.71)mm. The distance between the density point of the plexus and the synthesis point is (37.365.14)mm. The distance between coracoid process and the origin of axillary nerve is (24.632.53)mm. The distance between the density point of the plexus and the origin of muscularcutaneous nerve is (41.051.78)mm. The distance between the density point of the plexus and the origin of radial nerve is (31.233.15)mm. The distance between the density point of the plexus and the origin of ulnar nerve is (75.812.41)mm. The distance between the density point of the plexus and the origin of internal root of median nerve is (28.35 3.22)mm. The distance between the density point of the plexus and the origin of lateral root of median nerve is (25.814.00)mm. The distance between the density point of the plexus and the synthesis point is (55.202.25)mm.The left clavicle- bellowing part of brachial plexus: The distance between the density point of the plexus and the origin of axillary nerve is (30.152.39)mm. The distance between the density point of the plexus and the origin of muscularcutaneous nerve is (28.56 2.23)mm. The distance between the density point of the plexus and the origin of radial nerve is (36.953.61)mm. The distance between the density point of the plexus and the origin of ulnar nerve is (45.081.62)mm. The distance between the density point of the plexus and the origin of internal root of median nerve is (22.321.12)mm. The distance between the density point of the plexus and the origin of lateral root of median nerve is (14.113.50)mm. The distance between the density point of the plexus and the synthesis point is (40.523.91)mm. The distance between coracoid process and the origin of axillary nerve is (18.521.94)mm. The distance between the density point of the plexus and the origin of muscularcutaneous nerve is (47.823.62)mm. The distance between the density point of the plexus and the origin of radial nerve is (40.021.22)mm. The distance between the density point of the plexus and the origin of ulnar nerve is (66.183.55)mm. The distance between the density point of the plexus and the origin of internal root of median nerve is (30.621.87)mm. The distance between the density point of the plexus and the origin of lateral root of median nerve is (26.572.59)mm. The distance between the density point of the plexus and the synthesis point is(48.332.18)mm.5.The measurement results for the subclavius muscle and costocl- avicular ligament:The left side: The thickness of subclavius muscle is (1.540.31) cm. The thickness of costoclavicular ligament is (0.850.13)cm. The distance between the density point of the plexus and subclavius muscle is (0.420.17)cm. The distance between the density point of the plexus and costoclavicular ligament is (1.470.31)cm. The distance between the density point of the plexus and the arrest point of pectoralis minor muscle is (5.350.41)cm.The right side: The thickness of subclavius muscle is(1.720.21)cm. The thickness of costoclavicular ligament is (0.610.06)cm. The distance between the density point of the plexus and subclavius muscle is (0.690.09)cm. The distance between the density point of the plexus and costoclavicular ligament is (1.820.25)cm. The distance between the density point of the plexus and the arrest point of pectoralis minor muscle is (5.860.69)cm.Conclusion:1.It is the density point of nerve plexus that the center of clavical and coracoid process, where could be the point of nerve block, and may get ideal effect.2.The clavicle- bellowing part of brachial plexus has a close relationship with axillary artery. As a result, it is easy to suffer a co-injury of artery and nerve, to which should be paid great attention.3.The clavicle- bellowing part of brachial plexus has a close relationship with subclavius muscle, costoclavicular ligament, and pectoralis minor muscle. So related diseases may course a entrapment of brachial plexus sheath and lead to thoracic outlet syndrome. |
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